| Abstract | Cilj ovog rada bio je analizirati i usporediti razne grupe anksiolitika, ali i druge lijekove s anksiolitičkim djelovanjem, koji se danas koriste u terapiji anksioznih poremećaja i depresije. Anksioznost je stanje straha ili subjektivni osjećaj strepnje, zabrinutosti, napetosti, plašnje, slutnje da će se nešto loše dogoditi, a može doseći i razinu velikog straha i panike. Kao dominantni simptom javlja se u skupini bolesti koje se nazivaju anksiozni poremećaji, a kao prateći u brojnim drugim psihijatrijskim bolestima, ali i kod somatskih bolesti. Točan uzrok anksioznosti ni dan danas još nije sa sigurnošću utvrđen, no identificirana su neka centralna područja u mozgu povezana s njenim nastankom kao i ključni neutrotransmitorski sustavi. Glavni neurotransmitorski sustav odgovoran za anksioznost je gabaergički, stoga je on glavno ciljno mjesto djelovanja današnjih anksiolitika i novijih hipnotika. U povijesti su korištene brojne tvari i lijekovi u svrhu anksiolize kao što su alkohol, opijum, bromidi, klor-alhidrat, paraldehid, barbiturati, klor-metiazol, meprobamat i dr., ali posljednjih već više od 50 godina primat drže benzodiazepini kao lijekovi koji brzo djeluju, dobro se podnose, imaju relativno malo nuspojava, sigurniji su od drugih lijekova sličnog djelovanja, a primjenjivi su u širokom dijapazonu indikacija. U međuvremenu je otkriven i buspiron, lijek potpuno drukčije farmakodinamike od ostalih anksiolitika, usput i puno sigurniji, no na žalost nije uspio preuzeti ulogu benzodiazepina u terapiji anksioznosti. Osim ovih „klasičnih“ anksiolitika postoje i drugi lijekovi s anksiolitičkim svojstvima koji se s njima često kombiniraju s ciljem smanjenja rizika od razvoja tolerancije i ovisnosti. Među njima najvažniji su selektivni inhibitori ponovne pohrane serotonina i β-blokatori. |
| Abstract (english) | The purpose of my thesis is to analyze and compare various groups of anti-anxiety drugs, as well as other drugs that have anti-anxiety effect, used in modern treatment protocols for various anxiety disorders and depression. Anxiety is a state of fear or a subjective feeling of unease, worry, nervousness, or just a general feeling that something bad is going to happen. It can even reach a state of debilitating fear and panic. It is a dominant symptom in anxiety disorders, however, it can also be found as a secondary symptom in other psychiatric disorders, as well as in somatic illnesses. The exact cause of anxiety is, to this day, still uncertain, however, some central parts of the brain associated with anxiety have been identified, as well as key neurotransmitters. The most important neurotransmitter responsible for anxiety is GABA and that is why GABA receptors are the main target for modern anti-anxiety and hypnotic drugs. Through history many substances and drugs were used as anti-anxiety medications such as alcohol, opium, bromides, chloral hydrate, paraldehyde, barbiturates, clomethiazole, meprobamate and some others. However, for the last 50 years, benzodiazepines have been regarded as number one anti-anxiety drugs due to them being quick acting, well tolerated by the patients, having relatively few adverse effects and being safer in comparison to other similar drugs, as well as being applicable in a wide range of indications. In the meantime, buspirone was discovered. A drug with completely different pharmacodynamics than other anti-anxiety drugs, and also a lot safer, but sadly, it did not manage to replace benzodiazepines. There are also other drugs with anti-anxiety effects, other than “classic” anti-anxiety drugs, which are commonly combined to minimize the risk of tolerance and dependence development. The most notable are selective serotonin reuptake inhibitors and β-blockers. |
